2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 7. Pediatric basic life support

The 2025 Korean Guidelines for Pediatric Basic Life Support detail updated, evidence-based practices for resuscitating infants and children. Key updates include the strong recommendation for all rescuers to use the two-thumb encircling hands technique for infant chest compressions, the implementation of pediatric early warning systems (PEWS) in hospitals, the approved use of AEDs by lay rescuers for children over 1 year of age, and alternating 5 back blows with 5 chest thrusts for choking infants.

Pediatric cardiac arrest is primarily caused by asphyxia in infants and trauma in older children, distinct from adult cardiac arrests. Prevention is therefore paramount. The guidelines review prevention strategies (like water safety and SIDS prevention) and establish protocols for CPR and AED use by both lay and professional responders to maximize neurologically favorable survival.

Four major updates were introduced in 2025: (1) Implementation of pediatric early warning systems (PEWS) in hospitals; (2) Universal recommendation of the two-thumb encircling hands technique for infant chest compressions by all rescuers; (3) Suggestion for lay rescuer AED use in children aged 1 year or older with nontraumatic OHCA; (4) Specific guidance to alternate five back blows and five chest thrusts (using the heel of one hand) for infant foreign body airway obstruction.